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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 425801528
Report Date: 03/03/2025
Date Signed: 03/03/2025 02:56:44 PM

Document Has Been Signed on 03/03/2025 02:56 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:PATHPOINT LIFE LEARNING CTR LIFE CTR INDEPENDENCEFACILITY NUMBER:
425801528
ADMINISTRATOR/
DIRECTOR:		BERENICE JAIMES-LEONFACILITY TYPE:
775
ADDRESS:2450 PROFESSIONAL PKWYTELEPHONE:
(805) 934-3537
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY: 45CENSUS: 19DATE:
03/03/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Program Manager - Kellie EatonTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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At 1:15pm on 03/03/2025, Licensing Program Analysts (LPA) Haner-Tomasko and Jeffries arrived unannounced at the facility to conduct the annual, facility inspection. LPA met with the Program Manager Kellie Eaton and explained the reason for the visit being the full annual inspection.

Kellie Eaton and the LPAs toured the inside and outside of the facility. The following was inspected and noted during the annual visit:

Physical Plant & Environment Safety: The facility is located on the first floor of a commercial office building. The facility layout consists of multiple storage rooms, classrooms, and office spaces, each room has a different program function, and all rooms meet regulation standards. There are 3 bathrooms located throughout. There are liquid soap and paper towel dispensers in each of the bathrooms.

Planned Activities: The weekly activity calendar is posted on a large easy to read chalk wall located on the
wall across from the facility entry. A variety of activities were taking place during the visit. Clients were actively engaged in crafts and menu planning(cooking glass).

Infection Control: LPAs noted that the facility was clean and that all infection control regulations were being
followed.

Personnel Records & Training: Staff records are kept confidential electronically. LPA reviewed a sample
number of files for current 1st Aid/CPR, Health screening with TB results, training and fingerprint clearance.
Administrator is current on training requirements.
(Continued LIC809-C)
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: PATHPOINT LIFE LEARNING CTR LIFE CTR INDEPENDENCE
FACILITY NUMBER: 425801528
VISIT DATE: 03/03/2025
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Staffing: Today there are 2 staff present and 1 Program Manager.

Resident Records & Incident Reports: The facility keeps separate electronic files on each resident
confidentially. LPA reviewed a sample number of files for signed Medical Assessments, Pre-Admission
appraisals, and Appraisal Needs and Services Plans.

Food Service: LPAs noted a full kitchen located in the back of the facility, food for snacks are stored and a
refrigerator is available for refrigerated items. Clients bring lunch from home, snacks are provided as needed.

Incidental Medical & Dental: LPA observed a locked medication cabinet in the kitchen area, used when clients require medication management.

Disaster Preparedness: LPAs noted two emergency exits located in the back end of the facility and two at the front of the facility. LPAs observed working fire extinguishers throughout the facility. LPAs noted that no exits were blocked.

Program Manager and LPA conducted the full annual review of the CARE tool modules. No violations or citations were issued.

Exit interview, report read, report signed, and report delivered.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2025
LIC809 (FAS) - (06/04)
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